Assessment Tools and Diagnostic Tests in Adults and Children

QUESTION
When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.
Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.

To Prepare
Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests (option 1), or Child Health Case (Option 2). Note: Please see the “Course Announcements” section of the classroom for your assignments from your Instructor.
Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.
If you are assigned Assignment Option 2 (Child), consider what health issues and risks may be relevant to the child in the health example.
Based on the risks you identified, consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
Consider how you could encourage parents or caregivers to be proactive toward the child’s health.

The Assignment
Assignment (3–4 pages, not including title and reference pages):
Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:
A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
What is its purpose?
How is it conducted?
What information does it gather?
Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

Assignment Option 2: Child Health Case:
Include the following:
An explanation of the health issues and risks that are relevant to the child you were assigned.
Describe additional information you would need in order to further assess his or her weight-related health.
Identify and describe any risks and consider what further information you would need to gain a full understanding of the child’s health. Think about how you could gather this information in a sensitive fashion.
Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.
Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their child’s health and weight

SOLUTION
Child Health Case

Name
Department
Course
Date

Child Health Case
The case involves a child who presented having Hand, Foot, and Mouth disease and obesity. The patient was in the company of his parent and caregiver. Hand, Foot and Mouth disease affects many children under t6he age of five years. Despite the disease not being lethal, it spreads fast amongst children, especially in schools and daycare. In this case, the child, a pediatric patient, has reported reoccurring infection from the disease. The child showed multiple symptoms alluding to the disease. The visible symptoms included; sores in the mouth, skin rash and fever. The disease can be managed from home, but there is a need to consult health care practitioners in the event of contraction. The case presented had developed into a more complicated situation since the mother’s medical history suggested she had contracted the disease during pregnancy. Apart from the disease, the child was overweight and faced the risk of dehydration, although it could have been a result of the disease. According to (Marginean et al.,2018), child obesity is occurring at disheartening rates. The two health issues pose various risks to the health of the child. First, HMFD, if unchecked, can lead to a rare occurrence of aseptic meningitis and encephalitis through the development of the complications is dependent on its medical history. Secondly, obesity puts the child at the risk of developing high blood pressure and cholesterol. In the worst-case scenario, the child could develop cardiovascular disease. Additionally, there is the risk of impaired tolerance to glucose, resistance to insulin, diabetes mellitus and complications in breathing.
Data is vital in the assessment of weight-related health problems. Consequently, the child’s medical history is important while making an assessment. This is because obesity can be a hereditary problem. According to (Golden et al.,2020), genetic information contributes up to seventy percent risk of a child developing the disease. In addition, substantial data such as the child’s dietary culture will help in the assessment. High-calorie foods such as candy and ice cream, delicacies to children are huge contributors to exponential weight gain. According to (Lahoz-Garcia et al.,2018), there is a big relationship between and development of childhood obesity. Besides, sleep routines and the type of current medication also accelerate weight gain. Therefore, questioning the parents on the child’s sleeping patterns and diet is vital in assessing the child’s weight-related problem.
There are numerous risks involved with the child’s health. First, obesity poses the risk of cardiovascular disease due to high blood pressure. Additionally, high cholesterol levels could lead to the deposition of fats in blood vessels (Higashioka et al.,2019). Development of heart complications due to the deposition of cholesterol. Additionally, the child suffers from HFMD, which in extreme cases would accelerate dehydration. To further understand the child’s health condition, more information is needed to get more information. First, for weight-related health conditions, measurement of Biometric Body mass is crucial. A BMI above twenty-five is considered unhealthy and would indicate a critical condition.
Additionally, an interview with the parent and the caregiver seeking targeted response on the diet and nutrition of the child. Also, the insight into the child’s sleeping patterns by the parents or caregiver is vital in determining the child’s health status. Finally, the family’s medical history is also important in assessing obesity as a disease. There is a need to be sensitive to the patient’s and parent’s emotions to get information. As a result, an empathetic relationship must be created with the patient, making the patient and the parents feel comfortable sharing information. Personal health records are controversial. Therefore, the parents must be assured of the security of the data. It is important to understand the parent’s mood and emotions regarding the situation at the assessment moment. Consequently, timing is crucial. For instance, the risks may bring panic to the parents. So it is not right to try and get information from at the moment. The delivery of holistic healthcare demands cultural competence. Therefore, it is important to understand the parent’s perception of giving sensitive data such as medical history records. The respondent may be conservative; hence getting such information from them may make them feel offended.
When developing questions for the patient and the caregiver, it is important to consider their sensitivity. According to (Lawless,2020) holistic health care is not basic to patients but is attained through empathy. Sensitivity depends on the environment, emotion and cultural affiliation. In addition, the questions must be aimed at getting the targeted response to the child’s health assessment. In this case, to understand better the diet, nutrition, hereditary and the child’s medical history. Hence, the following questions will be appropriate to the parent.

Do you leave the child at daycare?
The question aims to determine the possibility of the child contracting HMFD since the disease spreads fast amongst children and the daycare is a red zone for contracting the disease. By doing so, the parent feels that it is not their fault the child contracted the disease. Therefore, considering their sensitivity to being responsible parents.
What are the child’s feeding and sleeping patterns?
The response to this question will give a deeper insight into the possible causes of obesity. As a health care practitioner, it is ethical to avoid being speculative when accessing a client. This question covers a provocative approach to the matter at hand. Inference can be made from the question without being insensitive.

Are there similar cases in the family?
Presenting the question in this manner navigates the prejudice attached to obesity by society. As a result, the parent will feel comfortable answering the questions.
An insensitive approach to questions can irritate the respondent, denying the practitioner respondent’s cooperation. In addition, they need to feel the empathetic side of the practitioner during the questioning. Assessment must be approached humanely and sensitively.
The parent and caregiver should adopt the following strategies to be proactive about the child’s health. First, they need to adopt a healthy diet for the child, especially by avoiding high-calorie fast foods such as candy and ice cream. High-calorie foods cause exponential weight gain that is detrimental to health. Secondly, the parent and caregiver need to develop an effective and healthy sleeping routine for the child. Unhealthy sleeping patterns are contributors to child obesity.
In conclusion, a pediatric health assessment is different from an adult assessment. This is because the parent or caregiver gives information on their behalf. Child obesity can be caused by a number of factors, including diet and genetics. Obtaining sensitive information such as medical records may be contentious. As a result, practitioners must be sensitive in the assessments. Health issues that can arise from weight include hypertension and cardiovascular disease. The child’s diet and sleeping patterns need to be changed to more healthy approaches to avoid such issues. Finally, being sensitive to a patient’s situation indicates cultural competence from the practitioner.

References
Golden, A., & Kessler, C. (2020). Obesity and genetics. Journal of the American Association of Nurse Practitioners, 32(7), 493-496.
Higashioka, M., Sakata, S., Honda, T., Hata, J., Yoshida, D., Hirakawa, Y., … & Ninomiya, T. (2019). Small dense low-density lipoprotein cholesterol and the risk of coronary heart disease in a Japanese community. Journal of atherosclerosis and thrombosis, 51961.
Lahoz-García, N., García-Hermoso, A., Milla-Tobarra, M., Díez-Fernández, A., Soriano-Cano, A., & Martínez-Vizcaíno, V. (2018). Cardiorespiratory Fitness as a Mediator of the Influence of Diet on Obesity in Children. Nutrients, 10(3), 358.
Lawless, B. (2020). Empath (olog) ic Pedagogy. Communication and Identity in the Classroom: Intersectional Perspectives of Critical Pedagogy, 45.
Mǎrginean, C. O., Mǎrginean, C., & Meliţ, L. E. (2018). New insights regarding genetic aspects of childhood obesity: a minireview. Frontiers in pediatrics, 6, 271.